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Wednesday, January 23, 2013

Rivalry in Federal Government threatens ACO Progress

With the newly announced 160 accountable care organizations this month, ACOs are bringing together rival hospitals. With those partnerships, however, also come fears of a healthcare monopoly.The U.S. Department of Health & Human Services announced 106 new ACOs, bringing the total to more than 250 since the 2010 Affordable Care Act passed. Among them is OneCare Vermont Accountable Care Organization, the nation's first statewide accountable care organization, the Associated Press reported. CareOne, which covers Vermont and New Hampshire, said on Friday that 42,000 of Vermont's 118,000 Medicare beneficiaries will receive care from the new entity.Read more: ACOs bring together rivals - Although encouraged by the ACA, ACOs are subject to review by federal anti-trust agencies that still worry collaboration teeters on anti-competiveness.

Read more: ACOs bring together rivals - he Department of Justice and the Federal Trade Commission apply a "rule-of-reason" analysis to ACOs, in which the agencies conduct a cost-benefit analysis in weighing the anti-competitive effects of the ACO with the benefits of the ACO.

"ACOs could grow so large in some areas that they will have a monopoly on the healthcare system," Enterprise Counsel Group, a law firm in Irvine, Calif., wrote in a statement Thursday. "If any two companies work together to coordinate pricing or share confidential information, anti-trust concerns develop."Read more: ACOs bring together rivals –Previously in June 2012 these concerns were stated

Depending upon which side of the argument you stand both sides argue they are there protecting the public, the FTC preventing monopolistic practices, leaving few if any other choices for patients, and ACO which is attempting to improve quality of care and reduce cost. Are the two mutually exclusive?

The conundrum once again emphasizes the size and disparate interests of federal agencies.

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Disclaimer

The opinions in this blog or other forms of social media are solely that of Gary M. Levin M.D. Dr. Levin has no financial interests in any medical devices which are discussed or which appear in the blog. Commentary taken from other sources are either quoted or referenced with attribution. Dr Levin does not endorse, nor give financial support to any political organizations.